Practices for Letting Go Safely in KAP
By Brian Shiers, MA CMF LMFT
There’s a lot of discussion about the preparation, guidance, and integration of the psychedelic experiences people have when using substances like psilocybin, MDMA, ketamine, and other mind-altering drugs in a therapeutic setting. Just as there are many modalities of therapy, there are many ways to support a client who wishes to explore their minds in an altered state.
Aims and Obstacles in Psychedelic Therapy
It helps to think of the aims and obstacles of psychedelic therapy to understand how a psychedelic / entheogenic journey may require support. From the client side, goals are often expressed as wanting to extinguish something: anxiety, depression, or PTSD, for example. Or sometimes the goal is more oriented towards finding something, like the answer to a difficult life choice, or a new beginning. From the clinician’s point of view, the aim is often to reduce the strength of the client’s defenses enough so that they experience a powerful shift in cognitive flexibility, informed by more robust affect.
When a client sees themselves, others, and the world in new ways, awash in a deep feeling of the Self, doorways open that can be capitalized on in the following weeks of integration, healing, creativity, and deliberate practice.
Of course, there is one huge obstacle from both the client and the clinician’s side: losing control and having a terrifying experience, one that could even regress symptoms. All the people I’ve treated – even those who’ve used psychedelics recreationally – express some anxiety about being overwhelmed just before they administer the medicine.
This is a healthy anxiety. It’s not unfounded.
Minimizing Overwhelm Through Buddhist-Inspired Practices
So how can we minimize the risk of overwhelm? Two tools from Buddhist psychology have served me and my clients well: Three-Sense Immersion, and Choiceless Awareness.
The former is constructed to develop concentration, to ground the mind in the safety of body sensations and the immediate environment, to reduce reactivity, and to enhance meta-cognition; the latter is designed to help the client discover the joy of letting go of the illusion of control while gaining the ability to influence the flow of unconscious material that surfaces.
Three-Sense Immersion
In Three-Sense Immersion, the client begins a meditation practice with eyes closed, tracking breath and body sensations for several minutes and following the common mindfulness instruction of redirecting attention back to the breath when noticing distractions.
The next step involves opening the eyes and relaxing into a very wide field of view to take in the panorama of the location, resting the eyes without creating tension and inhibiting the tendency to fixate on individual objects.
The step following that is to shift attention to sounds, letting the ambient acoustics be the focus for several minutes, releasing the tendency to ideate with every sound.
Finally, the client will attempt hold a wide-open field of awareness of sights, sounds, and sensations, releasing ideas and thinking to rest the flow of direct sensory experience.
Three-Sense Immersion helps ground the client firmly in the here-and-now and is useful for settling anxiety prior to a KAP session, as well as being very helpful in reorienting the client to the environment and their motor control in preparation for departure for home.
Choiceless Awareness
Choiceless Awareness is a practice for learning directly what letting go means.
Once entering a simple meditative state, the client rests in non-conceptual awareness, remaining open to any sensory, affective, or cognitive experience without using any kind of anchor while letting go of preferences, judgments, and even efforts to meditate.
The aim is to completely rest in being while bearing witness to all the psyche’s doing. In practice, the client slips back and forth between reactivity and detached observation, allowing them to have a little more agency in shifting the experience in intensity and content.
The Lasting Benefits of Mindfulness in Psychedelic Therapy
Taken together, these two practices go a long way towards familiarizing the client with their inner landscape, providing options for safe navigation of non-ordinary states of consciousness.
They also condition the mind in ways that have powered Third Wave modalities like MBCT, DBT, and ACT, and will likely contribute to ongoing growth, in the therapist’s office as well as in life. And as with all meditation practices, the clinician should be extremely well-versed in the techniques, themselves, to provide bespoke instruction and effective guidance.
Brian Shiers has been studying Buddhist meditation with renown instructors for over thirty years, is a senior teacher for UCLA Mindful, and provides the proprietary UC San Francisco mindfulness-based intervention instructional series, Enhanced Stress Resilience Training, to surgery residents at the UCLA Geffen School of Medicine. He is a clinical member of AIM Psychotherapy and provides KAP in-person at his office in Studio City, CA.
